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    KonsepLayanan TPA PLUS 22

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    Fakhriy Wibowo Edriatama
    The document discusses technology used by third party administrators (TPAs) to provide healthcare services to insured members when at hospitals. It outlines the procedures for outpatient and inpatient care, including claim registration and processing. It also discusses the surrounding healthcare systems, business projections using technology, infrastructure needs, and the application programming interface. The main application modules are listed for policies, membership, claims, finance, providers, and reporting. Screenshots of the main application interface are also included.

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    KonsepLayanan TPA PLUS 22

    Uploaded by

    Fakhriy Wibowo Edriatama
    8 views13 pages
    The document discusses technology used by third party administrators (TPAs) to provide healthcare services to insured members when at hospitals. It outlines the procedures for outpatient and inpatient care, including claim registration and processing. It also discusses the surrounding healthcare systems, business projections using technology, infrastructure needs, and the application programming interface. The main application modules are listed for policies, membership, claims, finance, providers, and reporting. Screenshots of the main application interface are also included.

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    The document discusses technology used by third party administrators (TPAs) to provide healthcare services to insured members when at hospitals. It outlines the procedures for outpatient and inpatient care, including claim registration and processing. It also discusses the surrounding healthcare systems, business projections using technology, infrastructure needs, and the application programming interface. The main application modules are listed for policies, membership, claims, finance, providers, and reporting. Screenshots of the main application interface are also included.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    8 views13 pages

    KonsepLayanan TPA PLUS 22

    Uploaded by

    Fakhriy Wibowo Edriatama
    The document discusses technology used by third party administrators (TPAs) to provide healthcare services to insured members when at hospitals. It outlines the procedures for outpatient and inpatient care, including claim registration and processing. It also discusses the surrounding healthcare systems, business projections using technology, infrastructure needs, and the application programming interface. The main application modules are listed for policies, membership, claims, finance, providers, and reporting. Screenshots of the main application interface are also included.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    of 13

    PHC APPLICATION

    TPA PLUS
    Persada Health Care Application

    Third Party Administration Plus

    SENTANA HEADQUARTERS
    Jalan Durian Jaya No. 10 RT 08 RW 05
    Ciganjur

    Jakarta, 29 Juli 2021


    TPA (third party administrator)

    Teknology yang digunakan


    dalam Layanan Kesehatan
    oleh TPA untuk Peserta
    Saat di Rumah Sakit

    facebook.com/sentana.persada.indonesia/ instagram.com/sentanapersada/ 2
    PT. Sentana Persada Indonesia
    • Rawat Jalan
    Prosedur

    facebook.com/sentana.persada.indonesia/ instagram.com/sentanapersada/ 3
    PT. Sentana Persada Indonesia
    • Rawat Inap
    Prosedur

    facebook.com/sentana.persada.indonesia/ instagram.com/sentanapersada/ 4
    PT. Sentana Persada Indonesia
    Surounding
    SYSTEM
    APLIKASI
    HEALTH CARE

    5
    Proyeksi Bisnis
    Kesehatan dalam
    Penggunaan
    Teknologi

    6
    Kebutuhan Infrastruktur

    7
    Kebutuhan
    Infrastruktur

    8
    APLICATION
    PROGRAMMING
    INTERFACE
    (API )

    facebook.com/sentana.persada.indonesia/ instagram.com/sentanapersada/ 9
    PT. Sentana Persada Indonesia
    Alur Sistem

    PT. Sentana Persada Indonesia facebook.com/sentana.persada.indonesia/ instagram.com/sentanapersada/ 10


    Modul Aplikasi
    POLIS
    01 Create Policy, Group Policy, Suspend Policy, Dedicated Account, Preview Policy

    MEMBERSHIP
    02 New Member, Endorsement, Voucher Member, Suspend Member, Re-Active Member, Upload & Download Member

    CLAIM
    03 Register/Batching, Claim ( Provider and Reimbursement), Supervisor Claim, Ex-gratia, Voucher Payment, Productivity Analyst, Excess of Claim

    FINANCE
    04 Receive Payment (Premium and Excess), Pay Bills, Pay Membership

    PROVIDER
    05 Provider Monitoring, Provider Dashboard

    CC - CM
    06 Guaranty Letter, Case Monitoring, Service Provider

    07 REPORTING
    Common Diseases, Benefit Claim, Top 10, Case Claim Member

    facebook.com/sentana.persada.indonesia/ instagram.com/sentanapersada/ 11
    PT. Sentana Persada Indonesia
    Tampilan Utama Aplikasi

    facebook.com/sentana.persada.indonesia/ instagram.com/sentanapersada/ 12
    PT. Sentana Persada Indonesia
    THANK
    YOU!
    Contact
    SENTANA HEADQUARTERS
    Jalan Durian Raya Ciganjur
    Jagakarsa Jakarta Selatan 12620
    Telp : (021) 72737820
    Marketing : 0811104533
    customer.support@sentanapersada.co.id

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